How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $208.93 Median $398.11 Typical High $2,137.96 | Facility | None | $208.93 | $398.11 | $2,137.96 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $213.80 Typical High $269.15 | Professional | None | $158.49 | $213.80 | $269.15 |
BCBS New Mexico Setting Facility Modifier None Typical Low $147.91 Median $302.00 Typical High $831.76 | Facility | None | $147.91 | $302.00 | $831.76 |
BCBS New Mexico Setting Professional Modifier None Typical Low $97.72 Median $218.78 Typical High $281.84 | Professional | None | $97.72 | $218.78 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $181.97 Typical High $1,202.26 | Facility | None | $151.36 | $181.97 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $263.03 Typical High $346.74 | Professional | None | $177.83 | $263.03 | $346.74 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $100.00 Typical High $302.00 | Professional | None | $33.11 | $100.00 | $302.00 |
Providence Setting Facility Modifier None Typical Low $158.49 Median $218.78 Typical High $1,288.25 | Facility | None | $158.49 | $218.78 | $1,288.25 |
Providence Setting Professional Modifier None Typical Low $186.21 Median $281.84 Typical High $354.81 | Professional | None | $186.21 | $281.84 | $354.81 |
United Setting Facility Modifier None Typical Low $199.53 Median $275.42 Typical High $1,380.38 | Facility | None | $199.53 | $275.42 | $1,380.38 |
United Setting Professional Modifier None Typical Low $162.18 Median $263.03 Typical High $354.81 | Professional | None | $162.18 | $263.03 | $354.81 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $89.13 Median $107.15 Typical High $125.89 | Professional | 52 · Reduced service | $89.13 | $107.15 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $42.66 Typical High $50.12 | Professional | 53 · Discontinued | $35.48 | $42.66 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $162.18 Typical High $186.21 | Professional | 54 · Surgery only | $134.90 | $162.18 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $32.36 Typical High $37.15 | Professional | 55 · Aftercare only | $26.92 | $32.36 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $21.38 Typical High $25.12 | Professional | 56 · Pre-op care only | $17.78 | $21.38 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $151.36 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $125.89 | $151.36 | $173.78 |
Where New Mexico sits
The same service costs 4.4 times more in Alaska than in Florida. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
New Mexico· 26th of 51
$234
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.